Senior Claims Audit Consultant in Irvine, CA at Willis Towers Watson

Date Posted: 9/13/2017

Job Snapshot

  • Employee Type:
  • Location:
    Irvine, CA
  • Experience:
    Not Specified
  • Date Posted:

Job Description

The Company

Willis Towers Watson is a leading global advisory, broking and solutions company that helps clients around the world turn risk into a path for growth. With roots dating to 1828, Willis Towers Watson has 40,000 employees serving more than 140 countries. We design and deliver solutions that manage risk, optimize benefits, cultivate talent, and expand the power of capital to protect and strengthen institutions and individuals. Our unique perspective allows us to see the critical intersections between talent, assets and ideas – the dynamic formula that drives business performance. Together, we unlock potential. Learn more at

The Business

Our Health and Benefits business helps large and mid-size clients control health and welfare plan costs, improve health outcomes and promote employee engagement through broad-based, state-of-the-art interventions.  We provide solutions encompassing creative plan design, vendor evaluation and management, pricing and funding strategies, data analytics, valuation support, compliance and governance strategies.  We also provide Specialty consulting services including clinical/health management program design, pharmacy solutions, disability/absence management strategies and claims audit services.  Product based solutions such as our pharmacy purchasing coalition round out our broad-based suite of offerings.

The Role

In this role you will be primarily responsible for developing new business, leading and delivering large client engagements and serving as strategic advisor to clients related to Claims Audits.  You’ll also be asked to contribute your thought leadership to the overall development of the Claims Audit practice and Health and Group Benefits business.

Performance Objectives:



  • Primary accountability for collaborating with other Willis Towers Watson leaders to create and execute a business strategy to penetrate the local and divisional market to:

    • Cross-sell Claims Audit products and services to current clients

    • Sell Claims Audit consulting services to new clients of the firm

  • Meet or exceed revenue and market penetration goals for the role


  • Serve as senior Claims Audit strategist on large client assignments, helping clients to:

    • Develop an audit strategy that optimizes health plan performance by identifying and correcting problem areas, establishing a baseline for vendor performance, and developing standards to guide plan administration

    • Demonstrate due diligence and fulfil plan sponsor fiduciary responsibilities by determining whether benefit programs are administered accurately and in accordance with contractual agreements

    • Construct pre-implementation audits for new vendors to focus on plan or benefit issues, vendor operations and customer service

    • Customize an approach to address unique concerns of the organization

  • Develop expert knowledge and experience of Claims Audit best practices, market trends, and products and services in the marketplace in order to contribute to the development of new tools, approaches and quality standards

  • Raise awareness of Willis Towers Watson’s capabilities in the marketplace through articles and conference speaking



  • Establish a trusted advisor role with clients and provide consistent, superior relationship management concerning Claims Audit issues

  • Collaborate with Health and Group Benefits and other colleagues to maximize the penetration of key accounts as they relate to Claims Audit services

  • Lead large Claims Audit consulting client engagements

  • Build leveraged teams that work effectively together
  • Develop plans for execution of large, complicated engagements
  • Ensure project managers are maintaining team progress against established budget, timeline and quality standards (while you have overall responsibility, consultant level staff typically serve as day to day project managers



  • Mentor and develop the expertise of Claims Auditors within the Central Division.
  • Build relationships internally with Health and Group Benefits consultants, the Client Development Group and consultants in other businesses to effectively collaborate on consulting opportunities
  • Educate other Willis Towers Watson colleagues concerning Claims Audit related intellectual capital and market trends

Job Requirements

The Requirements

  • Proven experience and success in selling Claims Audit services to premier clients, preferably gained in a benefits consulting or carrier environment

  • Proven experience successfully managing multiple projects and producing quality deliverables on time and within budget

  • Strong client relationship, interpersonal and team skills

  • A professional presence with polished and well developed oral and written communication skills

  • Self-starter attitude and ability to work with ambiguity

  • Flexibility and proven ability to diagnose and resolve issues

  • Strong analytical and creative skills

  • Business acumen to identify opportunities for additional Claims Audit or other human capital consulting work in support of our clients’ strategies

  • The ability to see the 'big picture,' leveraging the resources of related practices to address the clients' business challenges

  • Strong intellectual curiosity and desire to keep abreast of latest developments in Claims Audit and health and group benefits plan strategy and contribute to the development of new tools and approaches

  • Ability to work both independently as well as on a team, including interest in training/mentoring junior staff

  • Working knowledge of MS Office (Excel, Word, PowerPoint)

  • BA/BS degree

  • Ability to travel 40%


Any unsolicited resumes/candidate profiles submitted through our web site or to personal e-mail accounts of employees of Willis Towers Watson are considered property of Willis Towers Watson and are not subject to payment of agency fees. In order to be an authorized Recruitment Agency/Search Firm for Willis Towers Watson, any such agency must have an existing formal written agreement signed by an authorized Willis Towers Watson recruiter and an active working relationship with the organization. Resumes must be submitted according to our candidate submission process, which includes being actively engaged on the particular search. Likewise, for our authorized Recruitment Agencies/Search Firms, if the candidate submission process is not followed, no agency fees will be paid by Willis Towers Watson.

Willis Towers Watson is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to, among other things, race, color, religion, sex, sexual orientation, gender identity, national origin, age, status as a protected veteran, or disability.

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